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A Goal with Many Parts
Healthcare is ever evolving. Gone are the days where a patient’s wants, and needs are overlooked, and their opinions silenced. The nurse plays a major role in the healthcare system model. One of the most import roles that a nurse embodies is the one of being a patient advocate. A patient advocate supports the patient and enables them to have their voice heard and their wishes made known to others. A nurse advocate takes that a step further and protects the interests of patients when the patients themselves cannot because of illness or inadequate health knowledge. Developing a culture of safety is imperative as healthcare organizations continue to focus on patient centered care. This is part of the basis of Imogene King’s Theory of Goal Attainment.
The Goal Attainment
Type of Theory: A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing (Carol, 2015). The theory coined by Imogene King is identified as a grand theory. Nursing theories are categorized into two groups, grand or middle range. A middle range nursing theory is one that is precise and only analyses a specific situation with a set number of variables. provides a conceptual framework under which the key concepts and principles of the discipline can be identified. Theories that provide a conceptual framework under which the key concepts and principles of the discipline can be identified are known as grand theories.
Imogene King developed the Goal attainment theory in 1960. King’s Goal Attainment Theory accentuates the interrelationships of the patient and the nurse. The theory highlights the relationship in which a patient grows and develops to attain certain life goals. “As stated by King, a human being refers to a social being who is rational and sentient. He or she can perceive, think, feel, choose, set goals, select means to achieve goals, and make decisions.
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He or she has three fundamental needs: the need for health information when it is needed and can be used; the need for care that seeks to prevent illness; and the need for care when he or she is unable to help him or herself (Petiprin, 2016).” According to Alice Petiprin, the theory describes the factors which can affect the attainment of goals. These factors are roles, stress, space, and time (Petiprin, 2016). Within the theory there are three distinct models: personal, interpersonal and social. Petiprin states that, the concepts for the personal system are perception, self, growth and development, body image, space, and time. The concepts for the interpersonal system are interaction, communication, transaction, role, and stress.
The concepts for the social system are organization, authority, power, status, and decision-making. The nurse and patient participate jointly in setting goals and achievements based on the outcomes that are necessary or desired. In The Art and Science Of Nursing the Theory of Goal Attainment demonstrates nine major concepts: Nursing, Health, Individuals, Environment, Perception, Communication, Interaction, Transaction, and Stress (Carol, 2015). One of the main focuses of this theory is the total care and wellbeing of the patient.
The Four Main Concepts
The main nursing paradigms of are: Person, Environment, Health, and Nursing. Each metaparadigm plays a key role in the nursing process and is essential when providing patient care. “The concept “Individuals” is defined as persons exhibit common characteristics such as the ability to perceive, to think, to feel, to choose between alternative courses of action to set goals, to select the means to achieve goals, and to make decisions” (McEwen& Willis, 2011, p. 163). The metaparadigm of person focuses on the patient who is the recipient of care. This may encompass things such as a person’s spirituality, culture, family and friends or even their socioeconomic status.
Environment is the background for all human interaction. It involves both the external and internal environments. The external environment includes formal and informal organizations. The internal environment transforms energy to enable a person to adjust to continuous external environment changes. Patients perceive the world as a total person making interactions with individuals and the things around them in the environment. In this model, the nurse is part of the patient’s environment (Petiprin, 2016).
“The concept “Health” is described as a dynamic life experience of a human being, which implies continuous adjustment to stressors in the internal and external environment through optimum use of one’s resources to achieve maximum potential for daily living” (McEwen & Willis, 2011, p. 163).
“The concept of “Nursing” is defined as a process of action, reaction, and interaction whereby the nurse and client share information about their perceptions in the nursing situation” (McEwen & Willis, 2011, p. 163). Due to the increase in the tasks and the nurse to patient ratio it is easy to treat the physical diagnosis and move on to the next patient instead of taking the extra time to treat the patient as more than just a check mark on a list. King thought that it was important to include the patient in their plan of care and confirm their understanding of what was happening to them and in their surrounding environment.
Evidence based practice
The theory of Goal Attainment applies to my evidenced based practice question because of its main components. The Theory of Goal Attainment illustrates the nurse and patient interaction is necessary for the accomplishment of goals. It states that nurses purposely interact with the patients to established goals, and to explore and agree on the ways to achieve goals (Alligood& Tomey, 2010, p. 294).
My evidenced based nursing question pertains to purposeful hourly rounding to promote the health and comfort of the patient by the prevention of pressure injuries. Hourly rounding, which is also known as comfort rounding, is a proactive approach of communicating with patients and their families with the intent of anticipating their mental and physical needs. This is a nurse-driven, evidence-based intervention that helps us anticipate and address patient needs (Meade CM, 2015).
Conclusion
Nursing theories describe a multitude of concept sets, definitions, relationships, and assumptions. King’s Goal Attainment theory is the bases for how the patient should be incorporated into the treatment that they are receiving and the goals that are being set for them. As stated before the nurse should care for the complete patient and within that falls purposeful rounding and the promotion and attainment of health at the highest level. It is important that nurses are always striving to improve patient outcomes and with King’s theory in mind that will continue be possible.
References
- Patient advocacy in the community and legislative bodies
- Patient advocacy: Barrier or facilitator to patient-driven care
- Advocating for the hospitalized older adult: Research synthesis
- Patient Advocacy With Vulnerable Populations
- The Role of Nurses as Patient Advocates in the Prevention of Error and Malpractice
- The impact of nurse advocacy on patients with cancer in a hospital setting
